15600 SW 72ND AVENUE FILE NO.�q ;
72nd AVENUE - 15600 STR. OI','�. PERMIT
A fc�L-
Tigard Branch 24-22 036 015 603
UNITED STATES NATIONAL BANK 1230 NO.
01 Oregon
Tigard. Oregon
PAY lrf OF TIFARD . / '/
***FIVE 40NDRED SEVcNTY At.,r 4,:/ " LLA0S***
TO THE ORDER OF
O. CITY OF TIGARD
S.w. FIFTH�.:.. W AVE. NOT NEGOTIABLE
111
a R T L e N 0 r OR 97204 Author-zed Signature
Aulhomed dare
CITY OF TIGARD, TIGARD, OREGON 4.L. i R E E% CO. NO. 015603
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ISE 4 INV CATS tM0L4T � E P _
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73 PERF 3OND 1 / 6/E GOJ.yn r
1 /10/x$ 6r .7.,.4t
TOTAL 7r77�,y ,
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MILEAC..:
Date Description: (Include end/start readin s gnd total miles) Amount
Account Number: Total _ miles
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APPROPRIATION BALANCE: AS OF- Signature
APPROVALS (if $25.00 or under m imbursed through petty cash) :
(up to $500.00)Section Manager Purch. Agent
($500.01-$5,000.00)Dept. Nead/Purch. Apent.
l� 13125 S.W. HAL;_ BLVD.
P.O. BOX 23397
CITYOFTIFARD TIGARD, OR 97223
(503) 639-4171
OREGON
TO: FROM:
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SIGNED_- i c_ c '.�'y ^_ DATE
SIGNED— DATE-
PLEASE
ATE PLEASE RETURN ORIGINAL COPY WITH REPLY. KEEP PINK COPY FOR YOUR RECORDS.
FILE MPY
CI^ "OF TIFARD
PENDITURE RE)MBURSEMENT REQUEST
This form is a multi-use form. Where appropriate receipt, must be attached.
Documentation is important for all purposes. Staple documentation to form.
VENDOR NO: DATE:�_1
PAYABLE; TO: ���/_�_('' I(�, Requested by:./ r//
MISCELLANEOUS (parking, books, subscriptions, dues, memberships, etc. ) :
Date Description Account No. Amount
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/-Z -�" ScGG✓Cy���l`f%l(�/ � 61/Yf t, 1�.� . wev, j. � p00 ,! r `7, 4.0
GENERAL MEAL EXPENSE: I
Date Description Amount
�_AcIount Number to be charged: --- --� --Total J _
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MILEAGE:
Date Description: (Include end/start readin s and total miles) Amount
Account Number: u Total mi les x$.21
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APPROPRIATION BALANCE:: AS OF: Signat,ire
APPROVALS (if =25.00 or underm imbursed through petty cash) :
tul> to S500.()0)Sec I ton Manager ' Purch. Agee
"500.01-S5,000.00)Dept. Head/Purch. Agent _�r� -----_--- - —
10940 N.E. 33rd Place,Suite 103. Bellevue.WA 98004
Fax:12061827-7837 ELN:62887699 Telex: 328933 relephone.12001827-1315
Formerly trading/mm thr U S A
as Graham Miller Inc
Dt-cember 9, 1987
City of Tigard
P.O. Box 23397
Tigard, Oregon 97223
Attention: Michael C. Mills
Construction Inspector
Re: Assured : Doug Construction Company
Date of Loss : November 1984
Claimant : City of Tigard, Oregon
Our File No. : 3_7829_M
Dear Mr. Mills:
Thank you for your letter of 12 November 1987.
Please excuse my ignorance as to ownership or customers of the Tualatia
Water District. The 36" pipe in question belongs to the Tualatin Water
District, therefore, the question is if the sewer line had been rerouted
at the time the 36" main was installed, would this have been a chargeback
to Tualatin Water District and, in turn, to the City of Tigard fot the
sewer lateral. modification or would the Tualatin Water District have been
responsible in total for this change order?
As to the question presented in our first correspondence, Doug
Construction Company is bankrupt and Mr. Doug Gadd +.s living in
California and is not personally liable for financial obligations against
the corporation. As part of terms and conditions of his insurance policy
which would .address this loss, he had a $1,000 deductible. In the
interest of expediting settlement and in order not to create further
legal problems, we would be more than willing to absorb 1/2 of Mr. Gadd's
obligation ($500) and the City of Tigard would be willing to absorbing
the other $500. The insurors we represent are not legally responsible
for the first $1 ,000 of any claim.
Please present this offer of settlement to your principals and respond at
your earliest convenience.
/NTERNA"ONAI.AO/l/STF_RS
Houston•Los Angeles•Miami•New%irk•Rutland•San Franc iK o ,.;life
offices throughout UK.Europe.Middle Fait.Africa,Asia Australa,f.1 South Amerit a.nuf C.rrit+h.nn
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X4.41; —6 OOCc '7 14y-°e-, / ,(V, li,0411,le�,1AC-
17el
4.L..GREEN CO.
Date: November 2% 1987
Mr . Mike Mills Invoice No: 2`,02
City of Tigard
13125 S. W. Ball Blvd.
Tigard, OR 97223
Job No: 8536
INVOICE
past due notice regarding our invoice for the repair of sewer lane
at 15600 S. W. 72nd Ave. , Tigard, Oregon
The original invoice was mailen on April ?0, 1987 j '✓
Total Invoice $ 6, 923 .45 s ► f'
.85
1'hx interest on total thru 5-20-87 ---
103
Total Invoice $ 7 , 027 .30
1' % interest on total thru 6-20-87 -
105.41
New Total Invoice $ 7, 132.71
111% interest on total thru 7-20-87 106.99
108.99
1!1% interest on total thru 8-20-87 110.22
60
1�% interest on total thru 9-20-87 _ 111 .2`..'.•
1s % interest on total thru 10-20-87 TOTAI, NOW DUE S _—'D_
dJOcv. OLY ��tt��rAri
10940 N.E. 33rd Place,Suite 103, Bellevue.WA 98004
Fax:1206,827-7837 ELN:62887699 Telex: 328933 Telephone:(206)827-1315
Forme4y trading f im the L)5,A
as Graham Miller hic 26th October 1987 RECEIVED OCT 2 9 �yor
City of Tigard
13125 S.W. Hall Boulevard
P.O. Box 23397
Tigard, Oregon 9i223
Attention: Rand; S. Clarno
Development Services Manager
Re: Assured . DOUG G �NSTRUCfTON COMPANY
Date of Loss : November 1984
Claimant . City of Tigard
Our File No. . 3-7829-M
Dear Mr. Clarno:
This writer is the claims representative for the insuror of Doug
Construction Company who is no longer in business but was formerly
domiciled in Salem, Oregon.
From your correspondence of 28th September 1987 and the enclosures
provided, it appears Doug Construction's installation of the 36" fresh
water main may have caused damage to your 90 degree lateral sewage stub.
Before accepting liability on behalf of Doug Construction's insurors. we
do need some information and hopefully this will be in the form of
photographs of the damaged pipe once the hole was opened. Obviously it
is apparent to H.L. Green Company the cause of the lateral stub break was
Doug Construction's 36" fresh water main and we do note it was described
as being 12" below your sewer stub. Any help in this regard will be
greatly appreciated and will assist us in our liability evaluation. We
are sure your office can understand the difficulty in attempting to
examine a problem which allegedly occurred three years ago.
Please note, if liability is clear against Doug Construction Company, as
aforesaid, Doug Construction Company is no longer in business. Doug
Construction Company, under the terms and conditions of their insurance
policy accept the first $1,000 of all loss. This firs, $1,000 is
basically uncollectible. The insuror we represent is excess of Doug
Construction Company's $1,000 self-insured retainage. This question of
the first $1,000 of the loss can be addressed at a later date if
liability is clear.
INT•ERNAtIONAI A0/1.15rE'RS
Houcnm l o%Angele'.•Miarr; •New York•Portland•San f raou r.t,r ti•,,uh
lifticc� rhnurkheiul I Ile r:mope Middle 1:a%t Africa Asia.Auslralacia Suwh \n vtita and Carrhbean z
Randy S. Clarno
Page 2
26th October 1981
Thank you for your response in this matter and if you have any questions
whatever, please do rot hesitate to write or call.
Very trulv yours,
MAXSCN YOUNG ASSOCIATE'S, INC.
' J a M. Martin
Vice President
'-TW/1g
cc: Richard Alexander
c/o Stoel, Rives, Boley, Jones & Grey
cc: Robert Franz, Jr.
t:
CI 1 i O °' TIIVARD
OREGON
25 Yom of S&mk e
QA
f4ib1-14
86
September 28, 1987
Mr. Mike Stone
City of Tualatin Engineering Dept.
18880 SW Martinazzi. avenue
Tualatin, OR 97224
Dear Mr. Stone:
As we discussed the other day, the City of Tigard has receives: a claim of
$5,923.45 from H.L. Green Co., contractors, for a sanitary sever lateral
repair whieL oecarred-at 13600 SW 72nd Ave=*. It appears that we original
sewer latieiai was pot ;fin two during the construction of the City of !'nalatin's
36 imph " ; ysnror repaired (a" .*aolosed docum"tp),r .1. ,V*l.ogise
fog t i �� " t6tify You of these claims. goMr11►srr it appears
that the City of Tualatin is responsible for the !ost that H.L. Creon Co.
Incurred in waking theme necessary repairs. If you have any aueations
concerniug the details of this repair, please contact Mike Hills of our
office. Once you've had opportunity to review the matter in full, please give
me a call.
Sincerely,
-2,
r-z_
R ndy S. Clarno
Development Services Manager
eb/1O96D
I
I
19125 SWI Noll Blvod,po Box 23.491,flg*rtf,Oregon 97223 (503)639-4171 — -–-
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APPLICATION - STREET IMPRC -MENT/EXCAVA.T;ON COPY TO:
ORDINANCE NO. 74-14 (WHITE)•FILE
9(YELLOW)-INSP. '
(INSTRUCTIONS ON SEPARATE SHEET) (PINK)-OTHER AGENC q\/
`'(BLUE)-APPLICANT
APPROVED APPLICATION NO.: 287-
NOT
BZNOT APPROVED CITY OF TIGARD, OREGON /j �'-=-
FE' AMT. E_— Tj 'D'qq
PENDING FEC. PMT. ❑ CITY HALL RECEIP - p —
PENDING SECURITY G PUBL IC WO R KS DEPA R TMEN T BY DATE_ 3_ 130/ 87
PENDING AGENCY -OK- ❑ Application and P(Ogrt35 Record f
MAINTENANCE BOND N
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED -
ANNUAL ❑
FENDING VARIANCE ❑ _ - CXPIRATIONDATE:
PERMIT No. DATE ISSUED1--Z1 _ BY
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTAL.,(_ Ah oi'TA-cy- SJ�WIF-�_
AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT __ R•L•• CTri'h_--�N e,Q._—I�I�,Sy�. �FTf-I �V�---_- PQKT1- �P %�ZI`OQZU
ADDRESS CITY PHONE
CONTRACTORJ ��_AtGe _rrv��,3 3tli _1��` --_ j� JD -- - 1,��__
NAME ADbR St CITY PHONE
PLANS BY X&/LNZ/�Z��.•1-"Q 016W S.r�.� ytor-T _gyp f �—1 70
NAME ADDRES C. PHONE
ESTIMATED iMFROVEMENT TOTAL VALUATION ( COST $ _-9�_- __
DOLLARS
(2) EXCAVATION DATA: roR OrFICE Ust: -~ L-MIN.
0.04 X S --L-an eS 110
STREET DESCRIPTION PROGRESS_& INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM BATE REMARKS/Tt'PE BY
TYPE LENGTH WIDTH DEPTH ITEM A QUANTITY
SW• I / r �� . STPREET E
ND —
f� ? INSPE
C-
R TION
E —
Q
U -.
ESTIMATED STREET OPENING DATE;___ / 3c / 87 g
ESTIMATED STREET CLOSING DATE: 3— / 301 g� _ g !�—~
D
STREE
(3) SECURITY NO. . NIS_-_ SECURITY AMT: S�DOo • CLOSET
SURETY CO.: _ FINAL
_- --CERTIFIEUCHECK- ---- CASH •OND% INSPEC. 1•" ��' `I C G�5G� i
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT. OVA u Lp
-
I ( 1 1 ---
I 1 1 1
UR9
eEPMK Sg1t17Q1�y 1..4 tLr'�,t.
( � 1
1 � � I
(S) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCY WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PER fINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK. AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE �•GKcfN CD+ DATE ✓ ^ —
CITY OF TIgARD N 0. 2119 7
13125 S.W. HALL BLVD. -
P.O. BOX 23397 `----
TIGARD,OR 97223
i
Narne 1 -
Address _
Lot Block/Map SubdivisIon IAddress
ash Check
Permit N's Bldg. Plumb C
---
• Rec. B-`�
Other other Y
Sewer
- - - Amount
-� Descri tion
Acct. N0.
10.432 Building Permit Fees _
10-431 600 Plumbin Permit Fees -
10.431-601 Mechanical Permit Fees _ ---
10-230.901 State Bld . Tax
10-433 Plans
30.443 Sewer Connection
30-444 Sewer Inspection --- - --�
5t-448Street_5yst ev Charge -. -
52.449.610 Parks I Syst__DevCh
- arge --
52-44920 Parks II Syst Dev. Charge
v CharyFs
31-450 Storm Drainage Syst De
-
10 430 Business Tax
10 434 Alarm Perrn,t - -
10.221 eat I --
10499. Finer, tralttt a
_ -- ..
10.230-
CP1A ?ralltciMtsdlVu:
0.;4-W' Indigent 6etense --{
304 Sewer Sery+c� _
•121-4 7 -38Wer S�Brv�ce1C'ty 30''°
1 3 -9iA evicel "yflint -
-
:10 Unmatched
q Storm mage
Bancra''1 Olin Pymt
0-411 Mancroft Int PyrntTOTAL
DEPT.
rhi►
PLEASE TAKE THIS TO THE/ CASHIER FOR A RECEIPT /
NAME z /c 'v� �t' • ��7r_v�, �pr��txr�Ciy DATE: 3064 /?f97
A(;CT. N DESCRIPTION AMOUNT
1u 22000Refundable Performance Bond Deposit __ $
10-43500 _ Sian Permits HOP TU _ $
10-43600 Public Sewer Plan Check/Inspection Fee $
10 -43600 Public Storm Plan Check/inspection Fee $
10-43600 Street Dedication/Public Improvement Fee $
10-436CI Street Opening Permit ���� `�7 $ ¢D
10. 43601 Street and Traffic Marking _ $
21-44200 Street tight Fee $
10--43700 Subdivision Applications:
S MLP $
10 43000 Zoning Applications :
ZC CPA ZOA PD Misc
SCE CU SLPy
10 44CJ0 Other Planning Fees:
SDR
Non refundable portion of Appeal Fees $
10-2.2000 Refundable Portion of Appeal Fees
10 45!00 Document Sales:
Engrg. Planning Bldg. $ M
10-43000 Business Tax $ ---
TOTAL $
1045P/0023P